This is a randomized, controlled clinical trial of microneurosurgical anastomosis between the superficial temporal artery and the middle cerebral artery for prevention of stroke in patients with transient ischemic attacks related to the anterior cerebral circulation. Patients with such symptoms are admitted for workup which includes angiography and EMI Scan and isotope studies to quantify the blood flow in the brain. Randomization between a medical arm and a surgical arm is done after diagnosing the presence and severity of transient ischemic attacks.